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General NPI Number Information
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NPI Number | 1639683337
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Entity Type | Individual
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Provider Name | NINA MEZA RN
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Gender | Female
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Dates
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Enumeration Date | 11/17/2017
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Last Update Date | 11/17/2017
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Provider Practice Location Address
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Address Line | HIGHWAY 86 AND TOPAWA ROAD
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City | SELLS
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State | AZ
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Zip | 85634
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Country | US
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Telephone | 520-383-7414
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Fax | 520-383-7404
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | SELLS
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State | AZ
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Zip | 85634-0548
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Country | US
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Telephone | 520-383-7414
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Fax | 520-383-7404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN118043
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License Number State | AZ
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